title: Serologic markers associated with development of Crohn's disease after ileal pouch anal anastomosis for ulcerative colitis.
abstract: OBJECTIVE
  One of the causes of pouch failure after ileal pouch anal anastomosis (IPAA) for ulcerative colitis (UC) is the development of de novo Crohn's disease (CD). Our aim was to clearly define factors associated with post-IPAA CD.
  
  
  METHODS
  We conducted a cross-sectional study to compare demographic, clinical, and serological characteristics of patients with and without post-IPAA CD. All subjects underwent testing for anti-neutrophil cytoplasm antibodies, anti-Saccaromyces cerevisiae antibodies, anti-outer membrane porin C antibodies, and anti-CBir1 flagellin (anti-CBir1). A multivariable model assessed factors associated with post-IPAA CD.
  
  
  RESULTS
  Thirty-nine subjects were enrolled in the study: 20 cases and 19 controls. Patients who developed post-IPAA CD were significantly younger (median 22 ± 9.9 vs. 30 ± 11.3, p = .027) at the time of UC diagnosis and exhibited more extraintestinal manifestations compared to controls (p = .023). No significant difference between the groups was found with respect to family history, smoking, duration of illness prior to colectomy, time to the onset of pouchitis, preoperative treatment, and indication for surgery. However, the post-operative serologic profile differed significantly with far more cases having elevated anti-CBir1 titers (p = .016, OR 8.81), the latter being the only independent predictor in the combined model.
  
  
  CONCLUSIONS
  Patients with Crohn's disease of the pouch were more likely to have elevated CBir1 antibodies titers than those with simple pouchitis and healthy pouches. The stability of the CBir1 antibodies (pre- and post-colectomy) must be further assessed to establish its value as an independent predictor for development of post-IPAA CD.
authors.affiliation: , 99 Lupine Ave, #503, San Francisco, CA, 94118, USA, brindusa_73@yahoo.com.
authors.forename: Brindusa
authors.initials: B
authors.lastname: Truta
authors.forename: Dan X
authors.initials: DX
authors.lastname: Li
authors.forename: Uma
authors.initials: U
authors.lastname: Mahadevan
authors.forename: Elena R
authors.initials: ER
authors.lastname: Fisher
authors.forename: Yunn-Y
authors.initials: YY
authors.lastname: Chen
authors.forename: Kim
authors.initials: K
authors.lastname: Grace
authors.forename: Fernando
authors.initials: F
authors.lastname: Velayos
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Terdiman
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D002648:Child; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches; D003424:Crohn Disease / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood*; D016737:Proctocolectomy, Restorative; D012008:Recurrence; D055815:Young Adult
chemical_list: D015415:Biomarkers